With all respect, I've asked, whined, pleaded, and begged for help.
I totally agree when it comes to asking for help with sugar before vinegar. It made no difference, at least with the case worker who was representing him, and corresponding with the insurance co.
She tried.......they all did at the nursing home, but they were blindsided when it came to working with UnitedHealthcare.
The insurance, point blank, said that he could "make do" with the supplies he had, and left it at that. When he was done with what he had already been sent, they would send more.
I did manage to find a kind soul on the phone today who agreed to write up the order as a "swapout???" and get him the Jevity that he needs delivered tomorrow. But, I had to go through an ordeal of explaining how this was affecting him, not just physically, but mentally, before she agreed. Can you imagine being hooked up for 8 hours a day, just to maintain....not even considering trying to gain back the 30 lbs. he lost in the past six weeks? Let alone the wound packing, suctioning, dressing changes, trach care, etc.....?
He was esentially pushed out the door of the nursing home, b/c he was there for rehab after the stroke....yes, but it was the only place that was approved, b/c he wasn't approved for a longer hospital stay.
Insurance said he had to leave Hopkins. When the physical therapists discharged him at the nursing home b/c he could walk, dress, wash....etc.....the insurance co. wouldn't even listen to the nursing notes. (These were the original concerns for wanting to keep him in the hospital. Keep in mind he lost the use of his right arm.........he's right handed........not only did he lose his voice, he can't communicate at all now). They could care less at that point whether he aspirated, didn't care whether he had a suction machine. In their opinion, he didn't need rehab, so he wasn't worth paying for a bed in the rehab.
I'm telling you.........I'm a patient person, but this was b*llsh*t!
Thank God, I have a good nurse this time (only after threatening the head of the agency). We had to use the same facility that initially sent out the first two losers, b/c that is the only facility nearby that our insurance will recognize. (We are 15 minutes from DC and Annapolis.....go figure) He is the first who understands that a caregiver can't run on air alone.
He called the insurance himself today, and requested that I have a nurse a minimum of 4 hours a day. It is apparently something that I'm entitled to, but nobody will tell you about. With Dennis having a trach and PEG, it is protocal that it be provided. How can you be so money hungry that you don't let patients who need the services know that they are available?
I don't get it. Why?
Love,
Mandi
aka BB
